Early facial reanimation following radical parotid and temporal bone tumor resections

Article Abstract:

Surgery performed for tumors of the head, neck and base of skull can result in facial paralysis due to damage to the facial nerve. This muscle paralysis causes major cosmetic and functional abnormalities. It is possible to restore some degree of muscle function, and the functional, cosmetic and psychologic handicaps can be reduced if this restoration is done early. Choice of the appropriate method of facial reanimation (return to movement) is dependent on many factors. A discussion of results obtained in 35 patients treated with early intervention to reanimate the face is presented. The average age was 56. The initial surgery had required that the facial nerve be sacrificed during excision of the parotid gland and temporal bone. The most common reason (21 cases) for the initial surgery was cancer of the parotid gland. Reanimation surgery of the face was performed either immediately or within a few days. Reanimation of the eye was considered to be successful in 25 of 27 patients undergoing either weight implant or eyelid spring. Lower face animation was successful in 14 of 16 patients. Nerve graft or cross-over was performed in 22 patients. It is suggested that early reanimation can prevent some of the problems associated with longstanding paralysis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Surgery, Face, Movement disorders, Facial expression

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Lymph node staging in patients with clinically negative neck examinations by ultrasound and ultrasound-guided aspiration cytology

Article Abstract:

Patients with head and neck cancer may undergo neck dissection (lymph node removal) if the risk of hidden lymph node metastasis (cancer spread) is greater than 15 to 20 percent. Surgery can result in reduced shoulder function, facial swelling, and possibly decreased nerve function. Identification of cervical (neck) lymph node metastasis using ultrasound examination has been found to be superior to palpation. Ultrasound-guided fine-needle aspiration biopsy can give cytological (tissue) confirmation of metastasis. A study was undertaken to determine the usefulness of these procedures in identifying occult cervical lymph node metastasis; 107 previously untreated patients were studied. Prior to elective neck dissection, the patients underwent ultrasound study; the last 54 patients were also evaluated using ultrasound guided needle aspiration. The accuracy of ultrasound examination alone was 70 percent; the accuracy of ultrasound-guided aspiration biopsy was 89 percent (62 of 70 procedures). It is concluded that ultrasound-guided fine needle aspiration is the best technique for evaluating the neck for occult lymph node metastasis. This technique may also help avoid unnecessary elective neck dissection surgery for many patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Ultrasound imaging, Cancer metastasis, Head and neck cancer, Lymphatic metastasis

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Fine-needle aspiration of parotid tumors

Article Abstract:

Tissue samples may be collected for analysis in many ways, such as biopsy and fine-needle aspiration. The use of fine-needle aspiration (withdrawing cells through a thin needle) on tumors in the parotid gland is controversial because of the risks of facial nerve damage and excessive bleeding. The parotid is one of the salivary glands of the mouth. The accuracy and effectiveness of fine-needle aspiration for evaluating masses in the parotid glands of 64 patients were examined. Adequate specimens were collected from 72 percent of the patients. Tumors were correctly identified as benign or malignant in 93 percent of the samples: 11 out of 13 malignant and 32 out of 33 benign tumors were identified. No incidents of infection, facial nerve damage or any other complication were observed. Unnecessary surgery may be avoided by using fine-needle aspiration to differentiate between cancerous and inflammatory, noncancerous diseases. Using results from fine-needle aspiration along with information from the personal history and physical examination may be helpful in the treatment and management of parotid gland tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Mouth tumors

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